The Impact of Toilets in Health Facilities: A Patient’s Story

Namati’s health advocate in Mozambique’s Jangamo District received a number of complaints from patients regarding the lack of access to toilets at Jangamo, Mutamba, Cumbana, Ravene, and Ligogo Health Centres. The situation forced people to satisfy their physiological needs in the open air, compromising their dignity and reportedly affecting the retention of some patients undergoing antiretroviral therapy (ART) for the treatment of HIV.

One such patient, a 36-year old male who preferred that his name not be published, shared his experience. 

“I went for an appointment because I wasn’t feeling well. When I was in line, I started to experience stomach pains. I had to run around the health facility looking for a place to go to the bathroom. There was a toilet for patients, but after I peeked inside and saw how filthy it was I couldn’t bear to enter. I had no choice but to run behind a tree just to get some relief. It wasn’t a hidden thing. A lot of people were watching me in this situation, and I couldn’t escape from it. It was very embarrassing and upsetting for me.

“We have HIV-positive patients and TB patients taking drugs that can cause diarrhea. When these people go to a health facility without proper sanitation, they don’t feel comfortable. They think “let the diarrhea pass and then I’ll go to the hospital”. Others run the risk of missing their appointment. They prefer to stay at home where they are not surrounded by many people.

“Having experienced this shame when I went to the hospital, I took the opportunity to raise my concern at one of the health committee meetings here in the community. The committee invited me to help find a solution to this problem. We went to the health facility and asked to speak to the person in charge, but … he claimed to have no funds and referred us to the District Health Directorate. They too said “we also have no funds for the time being, but we will see what we can work out with our partners.”

Following several advocacy meetings, the District Health Director committed to finding a solution. A few months later, public toilets were built in Jangamo, Ravene, and Mutamba Health Centres.

“Today, everybody is comfortable. After seeing this issue resolved, I felt relieved. I felt very good because the benefit wasn’t just for me. It’s a benefit for the whole community. I think raising my concern was good for a lot of people.”

The Jangamo District Health Director, Carlos Issaca Simango, credited the collaboration between patients, the village health committee, and healthcare professionals for being able to resolve the issue.

“Following this joint work with the health committee and co-management committee, in coordination with development partners, it was possible to build conventional toilets in all the district health facilities which did not have them.  Our experience using the participatory health facility assessment process has made it much easier to ensure the equitable growth of all health facilities across the district, and we have seen greater user satisfaction with our health services.”


Banner image: A patient living with HIV (left) collaborated with a Namati’s health advocate (right), and village health committee members to ensure all health facilities in the district had toilets.

March 8, 2022 | Namati Mozambique